3rd opinion ??????

How are they classifying the cancers? My pathology uses e-cadherin testing to determine idc vs ilc.

Yes, me too, the treatment is the same I had 2 tumors one ilc and one idc.

Jessie, my KI 67 was very high (40%). I had my biopsy and initial diagnosis at my community hospital, and went to a major teaching hospital (and NCI designated cancer center) to see an oncologist based on my friend's recommendation. Said friend also had BC at 40. BC in young women is a more agressive disease, and my oncologist specializes in young women with breast cancer.

She told me I would likely need chemo based on the ki67 and grade (2 or 3), and offered me to enroll in a clinical trial that involved neoadjuvant chemo (chemo before surgery). I jumped on that opportunity, because experimental drug (which I didn't get, because I landed in the control arm) had good results. Anyway, before enrolling someone with ER+/Her2- cancer the trial required mammaprint, so I had it on the biopsy material. It came back High risk confirming what my oncologist have thought. I had chemo, and was lucky to have a very good response for someone hormone positive, HER2 negative. This type doesn't always respond to chemo, so I liked the idea of having it before surgery so that we could monitor response.

Chemo is no picnic, but at 40 I just wanted all they had in their arsenal.

My ovary was fine, but as a more aggressive hormonal treatment I was offered aromatase inhibitors. They only work on postmenopausal women, or those who are put in menopause chemically or surgically. I was on shot that was suppressing my ovarian function for several months after chemo and surgery, but then elected to have them removed.

As to my decision to have BMX, it was due to the fact that DCIS (non invasive cancer) was found in my other breast when my second hospital did an MRI. I think I commented on your post about the MRI. I suggest you do it if you consider the lumpectomy.

I don't know if the fact that I had cancer in both breasts was due to specific histological type: my left breast was non invasive and low grade. As per my oncologist, it could have become invasive 5 or 10 years later. I was, at the time, very upset with all this news: breast cancer, somewhat atypical cancer, cancer in another breast...

I now concentrate on the fact that I had good treatment, and am doing everything in my power to keep the cancer away.

I wish you peace in your decisions.

Meow, my mitotic score was also 1, both on core biopsy and on post surgical specimen. I admire your courage to go against doctor's recommendations. In my case, I sort of had a gut feeling I would need chemo. Even when nurse navigator at my first hospital told me I should do surgery and then decide based on Oncotype results. Since chemo melted away my 2.8 cm tumor down to tiny patches of cells, I am glad I had it. It was hell, I won't lie, and I still have waves of nausea when I think of the infusion room. I'm going for my regular follow up next week, and just the thought of having a blood draw in the cancer center makes me sad. But I don't regret my decision.

Based on some calculators that incorporate clinical stage before chemo and pathological stage after surgery, I'm getting 93 - 97% probability of being disease free at 5 years. I take this with a grain of salt, because statistics do not apply to an individual. My probability of getting BC at age 40 without family history and with my lifestyle (two pregnancies pretty early in life, breastfeeding for a total of 3 years) was under 1%, and I still got it.

Even those with low risk can get recurrence. I didn't have an Oncotype, and MammaPrint lumps everyone with high or low risk together, but if you read MINDACT trial results carefully, low risk mammaprint patients (those who are low risk both clinically and genomically) still have 2.3% probability of having a distant recurrence at 5 years. For the same trial distant recurrence in high risk patients (both clinical and genomic high risk, like me) had 9.4% chance of distant recurrence after chemo (90.6% distant metastasis free survival).

I don't know where I'm going with this . Just that after studying statistics carefully, and getting discouraged when I look at survival among young women or encouraged after I look at studies of patients who had good response to neoadjuvant chemo, I try to step away from my computer and just live life. I think the most important thing is being comfortable with your decision. I had some gut wrenching ones, and I agonized for a long time before making them. But once I made them, I never looked back.

I went for 2nd opinion.

If ur 1st and 2nd are different, I wld definitely go for a third opinion.

Linda

I had mixed IDC and ILC (with DCIS) and in places my e-cadherin was negative, others it was positive.

My pathology results from biopsy were HER2+ but then equivocal and finally negative after surgery. 

I got 4 opinions but after surgery. Keep going until you are comfortable.

As others have said, treatment will be the same. But treatment depends on tumor characteristics, ie, size, node involvement, hormone/Her2 positivity, and grade. Once these have been established you might want 2nd and 3rd opinions on treatment choices.

Mine was IDC with Lobular features. One report called it mixed. My understanding is that the E-Cadherin staining is how they decide which type it is. I believe positive staining means either IDC or possibly IDC with Lobular features as in my case. You might want to speak with the pathologist to get details on the tests that were done and what the results mean.

I am going to dig out my reports. Now I am very curious about exactly what they say about E-Cadherin.

jessie, lets go golf, I found this old thread discussing e-cadherin and tubular nottingham scores

https://community.breastcancer.org/forum/71/topics...